Grinding, a critical precision machining process for difficult-to-cut alloys, has undergone continual technological advancements to improve machining efficiency. However, the sustainability of this process is gaining heightened attention due to significant challenges associated with the substantial specific grinding energy and the extensive heat generated when working with difficult-to-cut alloys, renowned for their exceptional physical and mechanical properties. In response to these challenges, the widespread application of massive coolant in manufacturing industries to dissipate grinding heat has led to complex post-cleaning and disposal processes. This, in turn, has resulted in issues such as large energy consumption, a considerable carbon footprint, and concerns related to worker health and safety, which have become the main factors that restrict the development of grinding technology. This paper provides a holistic review of sustainability in grinding difficult-to-cut alloys, encompassing current trends and future directions. The examination extends to developing grinding technologies explicitly tailored for these alloys, comprehensively evaluating their sustainability performance. Additionally, the exploration delves into innovative sustainable technologies, such as heat pipe/oscillating heat pipe grinding wheels, minimum quantity lubrication, cryogenic cooling, and others. These groundbreaking technologies aim to reduce dependence on hazardous coolants, minimizing energy and resource consumption and carbon emissions associated with coolant-related or subsequent disposal processes. The essence of these technologies lies in their potential to revolutionize traditional grinding practices, presenting environmentally friendly alternatives. Finally, future development trends and research directions are put forward to pursue the current limitation of sustainable grinding for difficult-to-cut alloys. This paper can guide future research and development efforts toward more environmentally friendly grinding operations by understanding the current state of sustainable grinding and identifying emerging trends.